Abstract WP26: Determinants of Neuropsychological Function after Aneurysmal Subarachnoid Hemorrhage
Bibliographic record
Abstract
Introduction: Aneurysmal subarachnoid hemorrhage (aSAH) survivors suffer cognitive and behavioral challenges preventing their return to work and social activities. The factors that may affect neuropsychological outcomes after aSAH are not well characterized. This study aimed to analyze the clinical variables associated with the neuropsychological function in a large cohort of aSAH survivors. Methods: Patients with aSAH admitted to our institution since 2009 were recruited. Clinical variables, modified Rankin score (mRS) at discharge, hemorrhage volume, and the occurrence of vasospasm or new ischemia during hospitalization were collected. Patients underwent Montreal Cognitive Assessment (MoCA). Data was adjusted for sex, age, race, and years of education. Additionaly, patients completed the Beck Depression Inventory and the Stroke Specific Quality of Life questionnaires, while their families completed the Iowa Scale of Personality Changes. Univariate and multivariate analyses were performed to identify predictors of neuropsychological outcomes. Results: A total of 165 aSAH survivors were enrolled in the study. Short (32/165 patients) - and long-term outcomes (127/165 patients) were analyzed (3-12 months and 1 to 15 years post-aSAH respectively). In the short term, MoCA was significantly worse (<25 th percentile for adjusted data, p 0.003) in patients with high mRS at discharge (median 3, IQR 2) compared to low mRS (median 1, IQR 2, OR:2.14, p 0.006). In the long term, MoCA was significantly worse in patients with higher Hunt and Hess (OR: 1.39, p 0.09), higher modified Fisher grades (OR: 1.29, p 0.1) and in patients who developed new radiological ischemia during hospitalization (OR: 3.42, p 0.03). Larger total hemorrhage volumes were significantly correlated with worse MoCA performance (β: 0.97, p=0.048, figure). Radiological vasospasm (β: -0.40, p 0.006), new ischemia (β: -0.37, p 0.012), and higher Hunt and Hess grades (β: -0.30, p 0.053) were identified as predictors of poorer quality of life. Additionally, lack of stamina and executive personality changes were among the most frequently reported changes by family members post-aSAH for patients. Conclusion: Short-term cognitive outcomes following aSAH are associated with the mRS at discharge, while long-term cognitive outcomes are predicted by the severity of aSAH as assessed by clinical scales. The development of new ischemia after aSAH independently predicts long-term cognitive outcomes.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".